The overall objective of this proposal is to design a high quality Intervention Coordinating Center (ICC) which would serve the Reduction in Mortality and Morbidity Among Hemodialysis Patients (RMMAHP) Pilot Study and support the achievement of the five major objectives of that study. These are to: 1) design a pilot study protocol and write a Manual of Operations; 2) determine recruitment potential for a full-scale study; 3) detect short-term adverse effects associated with the experimental interventions; 4) implement procedures for the management of blood pressure, diabetes, and blood lipids and evaluate compliance to these modalities; 5) develop an inclusive intervention counseling model and a 'state of the art' program to insure care of the vascular access site; and 6) produce data which will allow for a better estimate of sample size required for a full-scale study. In order to fulfill these objectives the ICC will work collaboratively with the clinical centers, the Data Coordinating Center, and the staff of the National Institute of Diabetes and Digestive and Kidney Disease.